Long-term objectives: (1) To demonstrate that the NIS INDEX system may be used as a "stand-alone" information management system for journal articles in practice locations without access to computer technology. (2) To demonstrate that the INDEX may be used as a bridge or access link to Grateful Med searches of Medline. (3) To study the information access and usage behavior of physicians in a variety of practice locations and subspecialties, using both print and/or electronic versions of the INDEX system. Phase II specific objectives: Determine the usefulness and relevancy of the INDEX in patient care, residency education, and the Continuing Medical Education of practitioners. Both an enhanced INDEX and two forms of PC based INDEX will be tested to ascertain the impact on physician use. Methodology: Non-random selection of 20 sites, unblinded, prospective multi-center feasibility study; Pre and Post surveys; system use tracked thru data cards and computer software. Innovations: (1) Multi-location preview of INDEX contents thru Electronic Search Manual; (2) CD-ROM hard copy delivery for full length articles at peripheral locations. Commercial applications: HMOs, Group practices, rural practices, Residency programs, hospital libraries, medical insurance and malpractice companies. PROPOSED COMMERCIAL APPLICATION: On-site, hard copy clinical research, organized by topic, searchable in 2-3 minutes by the practitioner, has market potential of 16,000 group practices, 6000 hospitals, 600 HMOs, 400 residency programs, and numerous other health care organizations. Marketable through publishers, professional organizations, drug companies, and brokers/direct sales. CD-ROM and print distribution should yield multi-million dollar business.